In vivo assessment of pituitary volume with magnetic resonance imaging and systematic stereology: Relationship to dexamethasone suppression test results in patients

Axelson, David; Doraiswamy, P. Murali; Boyko, Orest B.; Escalona, P. Rodrigo; McDonald, William M.; Ritchie, James C.; Patterson, Linda; Ellinwood, Everett H.; Nemeroff, Charles B.; Krishnan, K. Ranga Rama

doi:10.1016/0165-1781(92)90070-j

Cited by 119 publications

(56 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Moreover, patients with major depression, where HPA axis hyperactivity has been consistently demonstrated, also have increased pituitary volumes (Axelson et al, 1992;Krishnan et al, 1991;MacMaster and Kusumakar, 2004). Indeed, in depressed patients, the pituitary volume is positively correlated with post-dexamethasone cortisol levels, suggesting that the pituitary gland is larger in those patients who show less suppression of cortisol secretion by dexamethasone, and thus have a more hyperactive HPA axis (Axelson et al, 1992).…”

Section: Discussionmentioning

confidence: 99%

“…Both old (Sachar et al, 1970) and recent studies (Ryan et al, 2003(Ryan et al, , 2004a have demonstrated hyperactivity of the main hormonal stress system, the hypothalamic-pituitary-adrenal (HPA) axis, in subjects experiencing their first psychotic episode. In turn, HPA axis hyperactivityFin major depressionFhas been linked to an increased volume of the pituitary gland (Axelson et al, 1992;Krishnan et al, 1991;MacMaster and Kusumakar, 2004). The pituitary gland regulates HPA axis activity by secreting the adrenocorticotropic hormone (ACTH), and its increased volume has been interpreted as reflecting an increase in the size and number of corticotrope cells producing ACTH (Axelson et al, 1992;Krishnan et al, 1991;Pariante et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

“…In turn, HPA axis hyperactivityFin major depressionFhas been linked to an increased volume of the pituitary gland (Axelson et al, 1992;Krishnan et al, 1991;MacMaster and Kusumakar, 2004). The pituitary gland regulates HPA axis activity by secreting the adrenocorticotropic hormone (ACTH), and its increased volume has been interpreted as reflecting an increase in the size and number of corticotrope cells producing ACTH (Axelson et al, 1992;Krishnan et al, 1991;Pariante et al, 2004). Indeed, in patients with major depression, the volume of the pituitary correlates with the circulating cortisol levels (Axelson et al, 1992;Krishnan et al, 1991).…”

Section: Introductionmentioning

confidence: 99%

“…The pituitary gland regulates HPA axis activity by secreting the adrenocorticotropic hormone (ACTH), and its increased volume has been interpreted as reflecting an increase in the size and number of corticotrope cells producing ACTH (Axelson et al, 1992;Krishnan et al, 1991;Pariante et al, 2004). Indeed, in patients with major depression, the volume of the pituitary correlates with the circulating cortisol levels (Axelson et al, 1992;Krishnan et al, 1991). Recently, we have described an increased volume of the pituitary gland, measured by magnetic resonance imaging (MRI), in 24 subjects with a first-episode of psychosis recruited in Melbourne, Australia (Pariante et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Increased Pituitary Volume in Antipsychotic-Free and Antipsychotic-Treated Patients of the Æsop First-Onset Psychosis Study

Pariante

Dazzan

Danese

et al. 2005

Neuropsychopharmacol

142

View full text Add to dashboard Cite

Subjects at their first psychotic episode show an enlarged volume of the pituitary gland, but whether this is due to hypothalamicpituitary-adrenal (HPA) axis hyperactivity, or to stimulation of the prolactin-secreting cells by antipsychotic treatment, is unclear. We measured pituitary volume, using 1.5-mm, coronal, 1.5 T, high-resolution MRI images, in 78 patients at the first psychotic episode and 78 age-and gender-matched healthy controls. In all, 18 patients were antipsychotic-free (12 of these were antipsychotic-naïve), 26 were receiving atypical antipsychotics, and 33 were receiving typical antipsychotics. As hypothesized, patients had a larger pituitary volume than controls ( þ 22%, po0.001). When divided by antipsychotic treatment, and compared to controls, the pituitary volume was 15% larger in antipsychotic-free patients (p ¼ 0.028), 17% larger in patients receiving atypicals (p ¼ 0.01), and 30% larger in patients receiving typicals (po0.001). Patients receiving typicals not only had the largest pituitary volume compared to controls but also showed a trend for a larger pituitary volume compared to the other patients grouped together ( þ 11%, p ¼ 0.08). When divided by diagnosis, and compared to controls, the pituitary volume was 24% larger in patients with schizophrenia/schizophreniform disorder (n ¼ 40, po0.001), 19% larger in depressed patients (n ¼ 13, p ¼ 0.022), 16% larger in bipolar patients (n ¼ 16, p ¼ 0.037), and 12% larger in those with other psychoses (n ¼ 9, p ¼ 0.2). In conclusion, the first-episode of a psychotic disorder is associated with a larger pituitary independently of the presence of antipsychotic treatment, and this could be due to activation of the HPA axis. Typical antipsychotics exert an additional enlarging effect on pituitary volume, likely to be related to activation of prolactin-secreting cells. This activation of the hormonal stress response could participate to the important metabolic abnormalities observed in patients with psychosis.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Increased Pituitary Volume in Antipsychotic-Free and Antipsychotic-Treated Patients of the Æsop First-Onset Psychosis Study

Pariante

Dazzan

Danese

et al. 2005

Neuropsychopharmacol

142

View full text Add to dashboard Cite

show abstract

“…2 Increased pituitary volume in these patients has also been described, and it has also been considered a marker of HPA axis activation. 16 In a recent study the first episode of a psychosis is associated with a larger pituitary volume, and suggested that this is due to activation of the HPA axis. The smaller pituitary volume in subjects with established psychosis could also be the consequence of repeated episodes of HPA axis hyperactivity.…”

Section: Abnormalities Of Hpa Axis In Depressionmentioning

confidence: 99%

O eixo hipotálamo-pituitária-adrenal, a função dos receptores de glicocorticóides e sua importância na depressão

Juruena

Cleare

Pariante

2004

Rev. Bras. Psiquiatr.

145

View full text Add to dashboard Cite

Objective: Changes in the hypothalamic-pituitary-adrenocortical (HPA) system are characteristic of depression. Because the effects of glucocorticoids are mediated by intracellular receptors including, most notably, the glucocorticoid receptor (GR), several studies have examined the number and/or function of GRs in depressed patients. Methods: Review scientific evidences have consistently demonstrated that GR function is impaired in major depression, resulting in reduced GR IntroductionHormones play a critical role in the development and expression of a wide range of behaviours. One aspect of the influence of hormones on behaviour is their potential contribution to the pathophysiology of psychiatric disorders and the mechanism of action of psychotropic drugs, particularly in major depression. Of all endocrine axes, the hypothalamic-pituitary-adrenal (HPA) axis has been the most widely evaluated. 1,2 The HPA axis plays a fundamental role in the response to external and internal stimuli including psychological stressors. Abnormalities in the function of the HPA axis have been described in people experiencing psychiatric disorders. Moreover, is well known the fundamental role of stress in precipitating episodes of psychiatric disorders in predisposed individuals. 1 These abnormalities seem related to changes in the ability of circulating glucocorticoids to exert their negative feedback on the secretion of HPA hormones through binding to the mineralocorticoid receptor (MR) and the glucocorticoid receptor (GR) in HPA tissues. 2,3,6 In fact, previous studies have described both an impaired HPA negative feedback, leading to hypercortisolemia, as in melancholic depression. 2,6 In addition to melancholic depression, a spectrum of other conditions may be associated with increased and prolonged activation of the HPA axis, including anorexia nervosa with or without malnutrition, obsessive-compulsive disorder, panic anxiety, chronic active alcoholism, alcohol and narcotic withdrawal, excessive exercising, poorly controlled diabetes mellitus, childhood sexual abuse and hyperthyroidism. 7 Another group of states is characterized by hypoactivation of the stress system, rather than sustained activation, in which chronically reduced secretion of CRH may result in pathological hypoarousal and an enhanced HPA negative feedback. Patients with post-traumatic stress disorder, atypical, seasonal depression and the chronic fatigue syndrome fall in this category (see Table 1). Similarly, patients with fibromyalgia have decreased urinary free

show abstract

“Seat of the soul”? The structure and function of the pineal gland in women with alleged spirit possession—Results of two experimental studies

Bastos

Paez

et al. 2020

Brain and Behavior

View full text Add to dashboard Cite

Background Cultural traditions attribute to pineal gland an important role for spiritual experiences. Mediumship and spirit possession are cultural phenomena found worldwide which have been described as having dissociative and psychotic‐like characteristics, but with nonpathological aspects. A sympathetic activation pattern in response to spirit possession has been reported in some studies, but empirical data on pineal gland is scarce in this context. Methods We aimed to investigate pineal gland and pituitary volumes, as well as urinary 6‐sulfatoxymelatonin levels in 16 alleged mediums (Medium Group‐MG) compared with 16 healthy nonmedium controls (Control Group) (Experiment 1). Furthermore, we aimed to evaluate urinary 6‐sulfatoxymelatonin and stress reactivity in GM ( n = 10) under different physiological conditions (Experiment 2). Results In Experiment 1, MG presented higher scores of anomalous experiences, but there were no between‐group differences regarding mental health or subjective sleep quality. Similar pineal gland and pituitary volumes were observed between groups. There were no between‐group differences in urinary 6‐sulfatoxymelatonin collected under equivalent baseline conditions. In Experiment 2, the rise of anxiety and heart rate in response to mediumistic experience was intermediate between a nonstressful control task (reading) and a stressful control task (Trier Social Stress Test—TSST). No significant differences were observed in 6‐sulfatoxymelatonin urinary levels between the three conditions. The pattern of stress reactivity during the TSST was normal, but with an attenuated salivary cortisol response. Conclusion The normal neuroimaging and stress reactivity findings in MG contrast with the abnormal results usually observed in subjects with psychotic and dissociative disorders.

show abstract

In vivo assessment of pituitary volume with magnetic resonance imaging and systematic stereology: Relationship to dexamethasone suppression test results in patients

Cited by 119 publications

References 15 publications

Increased Pituitary Volume in Antipsychotic-Free and Antipsychotic-Treated Patients of the Æsop First-Onset Psychosis Study

Increased Pituitary Volume in Antipsychotic-Free and Antipsychotic-Treated Patients of the Æsop First-Onset Psychosis Study

O eixo hipotálamo-pituitária-adrenal, a função dos receptores de glicocorticóides e sua importância na depressão

“Seat of the soul”? The structure and function of the pineal gland in women with alleged spirit possession—Results of two experimental studies

Contact Info

Product

Resources

About